Three-year effectiveness and safety of the XEN gel stent as a solo procedure or in combination with phacoemulsification in open-angle glaucoma: a multicentre study.

PURPOSE: To assess the 3-year effectiveness and safety of the XEN gel stent implanted ab interno in open-angle glaucoma (OAG). METHODS: This study was a multicentre, retrospective chart review of consecutive patients with OAG who underwent ab-interno gel stent placement alone or combined with phacoemulsification between 1 January 2014 and 1 October 2015. Outcome measures included mean changes in intraocular pressure (IOP) and IOP-lowering medication count from medicated baseline at 1, 2, 3 (primary outcome) and 4 years (if available) postimplantation. Intraoperative complications, adverse events of special interest (AESIs) and secondary surgical interventions (SSIs) were recorded. RESULTS: The safety and effectiveness populations included 212 eyes (primary and secondary) and 174 eyes (primary), respectively. Mean IOP and medication decreased from 20.7 mmHg and 2.5 at baseline (n = 163 primary/first implanted eyes) to 13.9 mmHg and 1.1 medications (n = 76) at 3 years postimplantation, respectively. Mean changes from baseline in IOP (-5.6, -6.2 and -6.6 mmHg) and IOP-lowering medication count (-1.8, -1.6 and -1.4) were statistically significant at 1, 2 and 3 years postimplantation, respectively. Results appeared comparable when implantation was performed with (n = 76) or without (n = 98) phacoemulsification. In primary eyes with 4-year IOP and medication count data (n = 27), mean IOP was 14.0 mmHg on 1.3 medications at 4 years postimplantation. Fifteen (7.1%) eyes had intraoperative complications, 31 (14.6%) experienced 46 postoperative AESIs, and 26 (12.3%) required SSI. CONCLUSION: The gel stent effectively lowered IOP and IOP-lowering medication count over 3 years, with a predictable and acceptable safety profile, when implanted via the traditional ab-interno technique.

Efficacy and safety data for the Ab interno XEN45 gel stent implant at 3 Years: A retrospective analysis.

PURPOSE: To report efficacy and safety measures of the XEN45 gel stent at 36 months in the UK National Health Service setting. METHODS: Retrospective non-comparative audit of the records of patients who underwent XEN45 implantation between June 2015 and May 2017 was performed. Main outcome measures were intraocular pressure and number of antihypertensive medications used. Failure was defined as need for further surgery or stent removal. Success was defined as a 20% decrease in intraocular pressure without the need for additional glaucoma medications or a reduction in antihypertensive medications without an increase in baseline intraocular pressure. Needling rates and preoperative factors effect were assessed. RESULTS: The cohort included 205 patients (205 eyes) with primary open angle glaucoma (84.4%), angle closure glaucoma (7.8%), or refractory glaucoma (7.8%), 62.9% had a stand-alone procedure and 37.1%, a combined phaco-XEN45 procedure. Mean intraocular pressure was 22.6 ± 7.0 mmHg at baseline compared to 14.7 ± 3.8 mmHg at 24 months and 14.0 ± 2.9 mmHg at 36 months (p < 0.001 for both). Mean number of medications used was 2.6 ± 1.1 at baseline compared to 0.5 ± 0.9 and 0.6 ± 1.0, at 24- and 36-months, respectively (p < 0.001 for both). The failure rate at 36 months was 25%. Needling was required in 36.6%. Evaluation of background factors yielded an increased failure rate in non-Caucasians compared to Caucasians (74% vs 21%, p < 0.001). CONCLUSION: XEN45 implantation is effective and safe at 36 months' follow-up. Patients should be advised regarding the risk of failure and possible need for bleb revisions. Careful patient selection may be required.

The Hydrotropic Effect of Ionic Liquids in Water-in-Salt Electrolytes*.

Water-in-salt electrolytes have successfully expanded the electrochemical stability window of aqueous electrolytes beyond 2 V. Further improvements in stability can be achieved by partially substituting water with either classical organic solvents or ionic liquids. Here, we study ternary electrolytes composed of LiTFSI, water, and imidazolium ionic liquids. We find that the LiTFSI solubility strongly increases from 21 mol kg-1 in water to up to 60 mol kg-1 in the presence of ionic liquid. The solution structure is investigated with Raman and NMR spectroscopy and the enhanced LiTFSI solubility is found to originate from a hydrotropic effect of the ionic liquids. The increased reductive stability of the ternary electrolytes enables stable cycling of an aqueous lithium-ion battery with an energy density of 150 Wh kg-1 on the active material level based on commercially relevant Li4 Ti5 O12 and LiNi0.8 Mn0.1 Co0.1 O2 electrode materials.

Impact of Anion Asymmetry on Local Structure and Supercooling Behavior of Water-in-Salt Electrolytes.

Salts with asymmetric (fluorosulfonyl)(trifluoromethanesulfonyl)imide (FTFSI) anions have recently been shown to suppress crystallization of water-in-salt electrolytes, enabling low-temperature operation of high-voltage aqueous rechargeable batteries. To clarify the underlying mechanism for the kinetic suppression of crystallization, we investigate the local solution structures and dynamic behaviors of water-in-salt electrolytes based on the asymmetric FTFSI anion and its symmetric anion analogues by Raman spectroscopy and molecular dynamics simulations. We find that monodentate coordination of FTFSI to cations leads to high rotational mobility of the uncoordinated SO2CF3 group. We conclude that the peculiar, coordination-dependent, local dynamics in the asymmetric FTFSI anion, manifested by enhanced intramolecular bond rotation, enables the strong supercooling behavior.

Efficacy and safety data for the XEN45 implant at 2 years: a retrospective analysis.

AIM: To report efficacy and safety measures for XEN45 in a National Health Service setting after 24-month follow-up. METHODS: This is a retrospective, non-comparative audit of records of patients who underwent XEN45 procedure between June 2015 and May 2017. The main outcome measures were intraocular pressure (IOP) reduction and number of antihypertensive medications at each timepoint. Failure was defined as requiring further surgery or removal of XEN. Success was defined as 20% reduction of IOP without additional glaucoma medications or reduction in antihypertensive medications without increase in baseline IOP. Needling rates were assessed and subgroup analysis was performed. RESULTS: A total of 151 eyes were included in the study. The main diagnoses were primary open angle glaucoma (84.1%), angle closure glaucoma (8.6%) and refractory glaucoma (7.3%). Stand-alone procedure was performed in 62.3% and combined phaco-XEN was done in 37.7%. The mean IOP at baseline was 22.1±6.5 mm Hg, and the mean IOP at 12 and 24 months was 15.4±5.9 mm Hg and 14.5±3.3 mm Hg, respectively (p<0.001). The mean number of medications was 2.77±1.1 at baseline, and 0.3±0.7 and 0.5±1.0 medications at 12 and 24 months, respectively (p<0.001). 25% of patients failed at the 24-month timepoint. Needling was required in 37.7% of patients at 24 months. Non-Caucasian ethnicity was found to be related to higher failure rate. No significant adverse events were noted. CONCLUSION: XEN45 is a viable, effective and safe procedure after 2 years of follow-up. Patients should be advised regarding failure rate as well as possible need for bleb revisions and medication use.

Water-in-salt electrolytes for aqueous lithium-ion batteries with liquidus temperatures below -10 °C.

Crystallization near room temperature is a common challenge for water-in-salt electrolytes. We demonstrate that water-in-salt electrolytes based on lithium (pentafluoroethanesulfonyl)(trifluoromethanesulfonyl)imide remain thermodynamically in the liquid state down to at least -10 °C. Combined with their excellent chemical and electrochemical stability as well as high lithium-ion conductivity, these electrolytes represent a key enabler for the next generation of high-voltage aqueous lithium-ion batteries.

CyPass® Micro-Stent Safety and Efficacy at One Year: What Have We Learned?

PURPOSE: The suprachoroidal pathway can potentially provide a viable target for intraocular pressure (IOP) control. We present efficacy and safety result for the CyPass® Micro-Stent that provides insight into the use of the suprachoroidal space for IOP reduction. MATERIALS AND METHODS: A retrospective, noncomparative audit of patient records in a university-affiliated National Health Service (NHS) hospital between June 2017 and August 2018. Main outcome measures were IOP reduction and the number of glaucoma drops taken at each time point. Failure and adverse events were noted for each patient. RESULTS: Seventy-seven consecutive case records of 69 patients underwent the CyPass® procedure between August 2017 and August 2018. A stand-alone procedure was performed in 37 (58%) of cases and combined phacoemulsification and CyPass® procedures were performed in 27 (42%) of cases. At baseline, the mean IOP was 24.6 ± 7.2 mm Hg. The mean IOP at 12 months' follow-up was 16.4 ± 4.5 mm Hg (p < 0.05). At baseline, the mean number of medications was 2.41 ± 0.98, which decreased at 12 months to 1.1 ± 1.3 (p < 0.05). Best corrected visual acuity analysis did not show statistically significant change preoperatively and at each postoperative time point. At 12 months' postoperative time point, 24% of eyes had failed. Significant IOP spikes were noted in 18 (28.1%) of cases. CONCLUSION: The suprachoroidal pathway appears to potentially offer an alternative to the classic subconjunctival pathways, yet present a new set of challenges. Further studies would have to address these concerns of endothelial cell loss, IOP spikes, and high failure rate. HOW TO CITE THIS ARTICLE: Gabbay IE, Ruben S. CyPass® Micro-Stent Safety and Efficacy at One Year: What Have We Learned? J Curr Glaucoma Pract 2019;13(3):99-103.

Magnesium Ethylenediamine Borohydride as Solid-State Electrolyte for Magnesium Batteries.

Solid-state magnesium ion conductors with exceptionally high ionic conductivity at low temperatures, 5 × 10-8 Scm-1 at 30 °C and 6 × 10-5 Scm-1 at 70 °C, are prepared by mechanochemical reaction of magnesium borohydride and ethylenediamine. The coordination complexes are crystalline, support cycling in a potential window of 1.2 V, and allow magnesium plating/stripping. While the electrochemical stability, limited by the ethylenediamine ligand, must be improved to reach competitive energy densities, our results demonstrate that partially chelated Mg2+ complexes represent a promising platform for the development of an all-solid-state magnesium battery.

Results of the betaxolol versus placebo treatment trial in ocular hypertension.

PURPOSE: To determine whether treatment with betaxolol can delay or prevent the conversion from ocular hypertension to early glaucoma on the basis of visual field criteria, by means of a prospective, randomised, placebo-controlled trial. METHODS: Three hundred and fifty-six ocular hypertensives were randomized to treatment with either betaxolol drops or placebo drops during the period 1992-1996. Each patient was followed prospectively with 4-monthly visits. Examination at each visit included visual field testing, intra-ocular pressure (IOP) measurement and optic disc imaging. Conversion to early glaucoma was defined on the basis of visual field change by AGIS criteria. An intent-to-treat analysis compared visual field conversion after 3 years in the treatment and placebo arms. Normal visual field survival analysis was also performed. The IOP characteristics of the two treatment groups were compared. RESULTS: Two hundred and fifty-five patients completed the study, which ended in 1998, with a range of follow-up of 2-6 years. Sixteen (13.2%) of 121 patients in the placebo group converted to glaucoma, compared with 12 (9.0%) of 134 patients in the betaxolol group. The intent-to-treat analysis demonstrated no evidence of any difference in conversion rates between the betaxolol and placebo groups after 3 years. Visual field survival analysis demonstrated no significant difference between the betaxolol and placebo groups. The betaxolol-treated group had significantly lower post-treatment IOP values. Converters had significantly higher pre- and post-treatment IOP values than non-converters. CONCLUSIONS: Betaxolol significantly lowered the IOP level compared with placebo. Conversion to glaucoma was found to be related to both the baseline and post-treatment IOP levels. However the intent-to-treat analysis did not demonstrate a statistically significant reduction in the conversion rate in the betaxolol-treated group.